• Neonatal Medicine
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• v.17 no.1
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• pp.34-43
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• 2010

Purpose : The aim of this study was to examine whether hypercapnia during the first seven days of life was associated with severe intraventricular hemorrhage (IVH) in preterm infants requiring mechanical ventilation. Methods : A matched pair analysis was performed for 19 preterm infants with severe IVH(grade$\geq$3) and 38 infants with no severe IVH (normal or grade 1), who required mechanical ventilation for more than seven days. The univariate and multivariate analysis of severe IVH with maximal and minimal $PaCO_2$, averag $PaCO_2$, SD of $PaCO_2$, and difference in the $PaCO_2$ were assessed. The major perinatal factors and maximal ventilator index (VI) were also compared. Results : Infants with severe IVH had a higher maximal $PaCO_2$ (86.1$\pm$18.4 mmHg vs. 60.1$\pm$ 11.6 mmHg, P <0.001) and mean $PaCO_2$ (47.5$\pm$5.6 mmHg vs. 41.2$\pm$6.3 mmHg, P=0.004) and a larger SD or difference in $PaCO_2$ (14.0$\pm$4.4 mmHg vs. 9.0$\pm$2.4 mmHg; 60.3$\pm$20.9 mmHg vs. 35.5$\pm$11.8 mmHg, P <0.001). However the minimal $PaCO_2$ values did not differ between the groups. Disseminated intravascular coagulation, pulmonary hemorrhage, and the air leak syndrome were more frequent in the IVH group than in the controls. The maximal VI on each day was higher in the IVH group. The multivariate logistic regression analysis after controlling for bleeding tendency showed that the air leak syndrome, maximal VI, and maximal $PaCO_2$ were independently associated with severe IVH [OR, 1.324 (95% CI, 1.011-1.733; P=0.041)]. Conclusion : Extreme hypercapnia was significantly associated with severe IVH in preterm infants, after adjustment for major perinatal risk factors. Frequent monitoring of the $PaCO_2$ may be important for early detection of inadvertent hypercapnia and prompt correction of high PaCOS levels.

• Journal of Veterinary Clinics
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• v.27 no.3
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• pp.262-267
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• 2010

Magnesium ($Mg^{2+}$) is an essential co-factor for over 325 physiological and biochemical processes so that plays a central role of neuronal activity, cardiac excitability, neuromuscular transmission, muscular contraction, vasomotor tone, and blood pressure significantly related to physical performance. However, only limited information on blood ionized $Mg^{2+}$ ($iMg^{2+}$) regarding to physical exercise is available and the data from blood total $Mg^{2+}$ detection are inconsistent. This present study investigated the changes of blood $iMg^{2+}$ correlated with metabolic demands during acute high-intensive exhaustive physical exercise in rats. After exhausted swimming (3-4 hours), blood pH, glucose, $HCO_3{^-}$, oxygen and ionized $Ca^{2+}$ ($iCa^{2+}$) were significantly decreased, whereas lactate, carbon dioxide, $iMg^{2+}$, ionized $Na^+$ and ionized $K^+$ were significantly increased. During the exhausted swimming, the changes in $iMg^{2+}$ showed a significant negative correlation with changes in pH, glucose, $HCO_3^-$ and $iCa^{2+}$, however a significant negative correlation with changes in lactate and anionic gap. It is concluded that the acute high-intensive exhaustive physical exercise could produced hypermagnesemia, an increase in blood $iMg^{2+}$ via stimulation of $iMg^{2+}$ efflux following increase in intracellular $iMg^{2+}$ from muscle induced by metabolic and respiratory acidosis.

• Korean Journal of Clinical Laboratory Science
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• v.48 no.2
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• pp.137-143
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• 2016

This study was conducted to investigate the electrolyte metabolic responses to a 100 km ultra-marathon in 22 male amateur runners. Their average age was $50.91{\pm}4.77$ years old and their $VO_2max$ value was $48.19{\pm}6.4 mL/kg/min$. The participants completed the race with a mean finishing time of $205.55{\pm}19.61$ minute. Electrolyte parameters based on blood tests including calcium, inorganic phosphorus, magnesium, sodium, potassium, chloride, total carbon dioxide, anion gap, plasma volume change and osmolality were measured pre-race, at 50 km, and at 100 km (post-race). Only slight changes in sodium level with no cases of hypernatremia or hyponatremia were observed. Additionally, all the electrolyte parameters changes were within the normal range and plasma volumes were unchanged. Overall, amateur marathon runners are not at risk to develop clinically significant electrolyte or osmolality changes during a 100 km ultra-marathon.

• Sleep Medicine and Psychophysiology
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• v.29 no.1
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• pp.4-8
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• 2022

Obesity hypoventilation syndrome (OHS) is defined as the triad of obesity (body mass index, [BMI] ≥ 30 kg/m²), daytime hypercapnia (PaCO2 ≥ 45 mm Hg), and sleep breathing disorder, after excluding other causes for hypoventilation. As the obese population increases worldwide, the prevalence of OHS is also on the rise. Patients with OHS have poor quality of life, high risk of frequent hospitalization and increased cardiopulmonary mortality. However, most patients with OHS remain undiagnosed and untreated. The diagnosis typically occurs during the 5th and 6th decades of life and frequently first diagnosed in emergency rooms as a result of acute-on-chronic hypercapnic respiratory failure. Due to the high mortality rate in patients with OHS who do not receive treatment or have developed respiratory failure, early recognition and effective treatment is essential for improving outcomes. Positive airway pressure (PAP) therapy including continuous PAP (CPAP) or noninvasive ventilation (NIV) is the primary management option for OHS. Changes in lifestyle, rehabilitation program, weight loss and bariatric surgery should be also considered.

• Tuberculosis and Respiratory Diseases
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• v.58 no.2
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• pp.160-166
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• 2005

Background : Although home oxygen therapy in hypoxemic patients with chronic lung disease has been increasing over the decade in Korea, the present state has not been known well. This study was done to know the situation of home oxygen therapy in a Korean university hospital. Methods : Between January 1, 2000 and August 31, 2003, 86 patients prescribed home oxygen therapy by the pulmonary physicians of Asan Medical Center were investigated using their medical record and questionnaire. Results : Patients (52 men, mean age of 61 years) with home oxygen therapy were increasing by every year. Underlying diseases were COPD (n=29), tuberculous destroyed lung (n=18), bronchiectasis (n=15), ILD (n=12), and others. Baseline $FEV_1/FVC$, FVC, and $FEV_1$ of patients were $58.4{\pm}25.2%$, $54.5{\pm}17.1%$ of predicted, and $41.7{\pm}20.6%$ of pred. Mean oxygen flow was 1.5 L/min and mean duration per day was 14.5 hours. During therapy, mean $PaO_2$ values have increased from 51.2 to 77.7 mm Hg and $PaCO_2$ values have increased from 47.5 to 49.6 mm Hg. Only 16.5% of the subjects were monitored by visiting nurses or pulse oximeter. Three year survival rate was 56.6% and hypercapnic patients showed better prognosis. Conclusion : The patients with home oxygen therapy were increasing yearly and a part of them were monitored. The hypercapnea respiratory failure patients would have better prognosis.